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Current advice and practical tips to ease back pain with sitting

What helps with back pain when sitting.
Kim Van Deventer
Kim Van Deventer
Mar 29, 2023
If your back hurts from sitting, this article can help. Learn why it happens, what posture is best, and how to adjust things to ease your pain.

Sitting with back pain can hurt even on the perfect chair. When you struggle to sit because of back pain, it can make working, driving, and socializing extremely challenging.

If you’ve ever been told, “don’t slouch, it’s not good for your back,” or to “just sit up straight” to make your back pain feel better, you’ll know that this isn’t always helpful advice.

The truth is, whether you sit with your back fully supported, slumped, or leaning back in a chair, any of these positions can make your pain feel better or worse.

In this article, we explain why back pain often worsens with sitting, discuss the best way to sit when you have back pain (according to current research), and give tips to help you sit comfortably in different settings.

Let’s start with how sitting affects your back.

Why your back hurts from sitting

Research indicates that sitting in uncomfortable positions for long periods can worsen existing back pain or lead to back discomfort in those without previous back issues.

Two likely reasons for this are:

1
Staying in one position for long periods reduces joint and muscle circulation.
Movement helps to circulate nutrients and waste products in and out of your back tissues, nourishing and keeping your back healthy, supple, and strong. However, when injured, that area of your body produces more fluid and substances that increase irritation. So, when you have a back strain or injury and sit too long, the extra fluid and irritants can accumulate, increasing your pain.
2
Static postures or always sitting in the same way (like always keeping your back straight) can increase muscle tension and strain your back structures.
If you sit in a way that feels difficult to maintain, your back and trunk muscles can fatigue and become tense, and you will think about your pain more, which increases it.

Common beliefs and misconceptions about posture and back pain with sitting

What is posture, really?

Posture is how you hold your body while standing, sitting, or lying down. It results from the combined effort of many muscle groups working together and is linked to your overall physical and mental health and well-being.

What is “good posture”?

“Good posture” is commonly understood as sitting straight, standing tall, and aligning your body. The assumption is that in a good posture, all your tissues align optimally for their expected job.

Back pain from sitting with "good posture".

What is “bad posture”?

"Bad posture" usually refers to sitting, standing, moving, or lifting with your body not aligned, your back bent, and your shoulders hanging down.

Back pain caused by "bad sitting posture".

What do people believe about sitting posture and back pain?

Many people (including healthcare professionals) think that sitting with “good posture” helps protect your back and keeps it from hurting, and sitting with “bad posture” can injure your back and make it hurt.

What does the current evidence say about back pain and sitting posture?

Evidence shows that these beliefs about posture and back pain are widespread but unhelpful and often get in the way of people fully recovering from back pain.

The review of the science shows that:

  1. No single “correct” posture can cause, ease, or prevent back pain.
  2. “Good” posture doesn’t prevent back pain, and “bad posture” doesn’t cause it.
  3. Sitting in any posture for a long period can lead to discomfort, regardless of the posture itself or whether you have back pain or not.
  4. Your stress and anxiety levels, sleep habits, strength and fitness levels, and genetics link more strongly to developing back pain than posture.
  5. Focusing on staying fit and active, sitting in more comfortable, relaxed positions, and regularly changing them up is more effective for reducing sitting-induced back pain than always trying to maintain one “perfect “posture.

Now let’s look at finding relief from back pain while sitting.

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How to minimize back pain while sitting

Everyone’s body structure, symptoms, and back pain are different, so the postures you find comfortable will differ from others.

However, according to current advice, the best posture is the one that feels the easiest and most comfortable for you to maintain. So, aim to be more relaxed, add support when necessary, and sit as effortlessly as possible.

Another important factor for avoiding back pain with sitting is regularly adjusting your position and taking breaks before the pain increases. In that way, you’ll likely be able to tolerate sitting for more extended periods than if you only take breaks after you start feeling pain.

Below are some tips you can follow to help you find some relief from back pain while sitting in various settings. Remember, this advice is only a guide to help get you started, and you should tailor it to meet your needs.

The back pain rehab plan in the app incorporates helpful tips and advice on managing pain in your daily life so you can avoid setbacks and keep progressing through your recovery.

Tips for when you get back pain from driving

If you get back pain when driving, the following adjustments may help:
1
Adjust your car seat each time you drive
Set it to the appropriate height, angle, and distance from the dashboard so you can see the road easily and reach the pedals and steering wheel without straining.
2
Keep your back and thighs well-supported
If it feels more comfortable, consider adding back and thigh support (e.g., a seat cushion under your bottom and thighs or a rolled-up towel behind your lower back)​​​.
3
Position your headrest properly
Support your head, neck, and shoulders enough so your back can relax.

Tips for if you get back pain when sitting at a desk

If you regularly find yourself experiencing back pain when sitting at a desk, you can try the following:

1. Use a dynamic, ergonomic chair if necessary (and possible)

No chair is best for back pain. However, chairs with movement mechanisms, adjustable armrests, and seat depths may be helpful to you.

These can keep your back better supported and mobile, which may help you sit more comfortably for longer periods.

2. Assess and adjust your work chair regularly

Studies show comfort levels with certain positions can change when you have back pain; you may find the chair settings you found comfortable a week ago are less comfortable now.

3. Be more active and mobile at work

Avoid back pain by being more active at work.

A sit-to-stand desk can help you find the right balance between sitting and standing to ease your back pain at work. Also, doing back pain rehab exercises, taking short walks, and moving regularly throughout the day can help reduce back pain when sitting.

Note: Don’t worry if you work in different places or you don’t have access to adjustable desks and chairs. You can still make small changes to your sitting position and workstation set up throughout the day to stay comfortable.

Tips for if your back hurts at other times while sitting

If you have a choice, it can help to:
1
Choose soft but firm chairs and surfaces to sit on
Too-soft surfaces (like some sofas) allow you to sink in too deeply and increase your back pain
2
Sit on chairs with backrests
Choosing a seat with backrests ensures you have the option to support your back if necessary and gives you the ability to change your position regularly
3
Add extra lower back support if possible
Sitting very upright without any back support can make your muscles tired and often increases back pain; a cushion, rolled-up blanket, or towel behind your lower back can help keep you sitting comfortably for longer
4
Keep your feet supported
Preferably flat on the ground, but having them supported evenly on a foot bar or footstool can also help
5
Perch if sitting down hurts too much
Resting your bottom on a high chair or stool can often feel more comfortable; it also helps to break up long periods of sitting

Conclusion

Back pain is a complicated condition, and easing pain with sitting takes more than simply focusing on “good” or “bad” posture.

While adopting more comfortable postures and regularly adjusting them can help reduce back pain with sitting, other factors are usually also involved. These include muscle strength and endurance, pain beliefs, stress levels, sleep patterns, and more.

Taking steps to improve your physical and mental health as part of a comprehensive rehab program can reduce your back pain, making sitting easier and less of a burden.

If you would like to learn more about the different types of back pain and how to start treating yours effectively, our back pain overview article explains everything you need to know about it.

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Kim Van Deventer
Kim Van Deventer
Kim Van Deventer is a freelance healthcare writer and digital content strategist for healthcare businesses and medical content agencies. She worked as a physiotherapist for more than 14 years, specialising in sports injury rehabilitation, chronic pain management, and women's health. Kim combines her clinical experience and digital marketing skills to create relevant and helpful content that improves patients' lives.
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